Rich Vosler writes:

On November 11, 2004, my wife Joanne woke up with a severe stomach ache. She called me at work to tell me that she had vomited that morning and didn’t know what was going on. The pain continued through Friday and then through the weekend. She told me at one point that this pain was worse than any labor pains she ever had. That scared me. Our newest baby, James, our 9th  child, was only 6 weeks old.

On Monday morning, November 22, she called and made an appointment to see our family physician. Then she called me at work and asked me if I’d meet her there. I told her I would but thought she was overreacting. I was really busy at work and was a little aggravated to be honest.

I got to the appointment a little late and sat down in the small waiting room. No sooner had I opened a magazine when the door to the examining room hallway opened. Joanne walked out and she did not look right. She said, “He’s sending me for a CT scan and he wants the results STAT.” I angrily said, “What for!?!?” Just then the doctor walked in behind her and said, “I can feel her liver through her abdomen. Her liver is very swollen.” I had been going to this doctor for 7 years and the look on his face was unlike any I had ever seen. He looked scared. Now I was really concerned. He said, “They’ll take the pictures, and I want you to wait for them and bring them back to me right away.”

After getting the scan, we went right back to his office. He looked at the scans and then came into the examining room where we were and quietly closed the door. He looked grimly at Joanne and me and said, “You have 8-10 tumors on your liver. Some are the size of softballs.” We just stared in disbelief. “How is that possible,” I asked. “I don’t know,” he said. “But I know a doctor down the hall that I want you to go see. He and I have gotten to know each other and he’s really good. I want you to go there from here and make an appointment as soon as possible and he’ll keep me updated.” He handed me the doctor’s business card and when I looked at it and saw the word “Oncologist” I was floored. Joanne said to me, “That’s a cancer doctor.” I said, “He’s probably sending us there just as a precaution. You can’t have cancer. You’re in perfect health.” She didn’t look as confident. I was confident because the doctor never told us he thought it was cancer. When he said goodbye, he put his hand on my shoulder as if to say, “Brace yourself. What you’re about to go through is going to be the toughest journey of your life.” His expression wasn’t lying.

After several days Joanne and I got in to see the oncologist. The practice he was in was huge with several doctors and the office was as busy as a sidewalk in Manhattan during lunch hour. I couldn’t believe that all these people were actually going to see oncologists. I still held the belief that we were there only for precautionary reasons.

The nurse called us into the examining room where we waited almost an hour. Several times the doctor rushed by our room but never came in. Finally, I saw him in his office across the hall reviewing Joanne’s file. He came in, introduced himself to us, closed the door and explained what he saw. We had trouble understanding the medical jargon because of our limited experience and because he had a thick accent. He told us that he wanted to set up a biopsy to see if this was a fast growing cancer or a slow growing cancer. Surprisingly, I looked at him and said, “So this is cancer???” And he said, “Oh yes. I knew it was cancer as soon as your primary doctor called me.” I felt like I was dreaming. My breathing seemed to stop and all motion, sound and sight seemed to freeze. I looked at Joanne and she was wiping tears from her eyes. The doctor was visibly upset and said, “I’m so sorry. I thought you knew.” When I told him this was the first time we knew it was cancer he was visibly upset and his eyes began to fill up. He knew that we had 9 children and he said, “Prayer is very helpful in these situations. Pray yourselves and get as many people as you can to pray for you. If it’s slow growing that’s the best news we can ask for.” He explained that once he knew what kind of cancer it was, we’d talk about a plan of action including chemo, radiation and whatever else would work. 

Joanne and I left that office dazed. One of the nurses saw how distraught we were and pulled us into a waiting area to comfort us. After a few minutes Joanne said, “I’m ok. Let’s go home. I want to go home.” I took her arm and we walked to the door. As soon as we got into the hall, Joanne fell to the ground in tears. People were walking past us and looking on us with pity. One woman asked if we were ok and I told her we were. I didn’t feel like sharing what we were just told. Joanne sobbed, “I don’t want cancer...I don’t want to die…What about the kids…What are we going to do Rich???” I did the best I knew how which was to kneel down next to her and comfort her. I said, “Joanne, you’re not going to die. We don’t even know what kind of cancer this is. He said it could be slow growing which is a good thing. We have to stay positive and focus on beating this.” “I don’t want to die…..”

I managed to get Joanne back on her feet and we walked arm in arm very slowly to the elevator as Joanne leaned on me crying. I remember it took forever to get to the car. When we got into the car, I started it and Joanne and I embraced. “Don’t worry I told her. We’re going to beat this. We can’t jump to conclusions because we don’t know the extent of this yet.” For the time being we were remaining optimistic.

When we got home Joanne was still in a lot of pain. We went up to our bedroom and she wanted to get into bed. I tucked her in and then laid next to her. Our bedroom had only one small window in the front of the house and it was very dark even during the day. The colors were a soft pink and the lights we had didn’t do the room justice. After a while Joanne said, “We better tell my mother.” I asked her if she was sure and she said she was. I went down stairs to get her mother who was babysitting for us while we were at the doctor. “Mom? We need to talk to you upstairs,” I said choking back tears. My eyes felt tired, heavy and sticky. “What’s the matter? What’s wrong,” she said. “Just come upstairs and we’ll tell you.” When we got back into the bedroom I sat on the bed next to Joanne. “We have some bad news to tell you,” I started. “What? What?” With my voice shaking and cracking and tears rolling down my cheeks I said, “We found out at the doctor today that Joanne has cancer.” There was total silence in the room. I remember like it was this morning. Her eyes started tearing up immediately and she grabbed Joanne to hug her and they both cried for several minutes. This was not a new conversation for Joanne’s mom. She had so many people on her side of the family that died from every kind of cancer imaginable. I could sense that this was her worst nightmare. If she could have taken the cancer on herself instead of Joanne I know she would have.

Now came the toughest part-telling the kids. Shortly before dinner after they all got home from school, I told them that we had to talk to them upstairs in our bedroom. They thought they were in trouble because it was never good when Dad called an impromptu family meeting. Joanne had stayed up there for the whole day and her mom was up there with her for most of the day as well. I sat on the bed next to her holding the baby as the kids came in and stood all around our bed. When everyone was in, I said, “We found out something from the doctor today about mommy that we need to tell you. But before I tell you I want you to understand that we don’t have all the information yet and we’re not really sure what the extent of everything is. We found out today that mom has cancer.” Nicole, our oldest and 13, was the most visibly upset. Less than a year before, one of her close friend’s father had died of cancer. She started crying and jerked back as if her knees were buckling and said, “No!” The other older ones followed suit and started crying and the younger ones just stared at us not understanding what this meant. They started crying after a few minutes of watching their older brothers and sisters.

One of them, I forget which, asked, “Are you going to die?” And Joanne said, “No honey I’m not going to die. Like Dad said, we don’t have all the information yet so we’re not sure how bad it is. But we’re going to fight this thing. Ok? Everything is going to be ok. Mommy’s going to be fine.”

What began from there were endless doctor visits and countless hours spent in waiting rooms, radiology departments and hospital emergency rooms. We found out that Joanne had what’s known as carcinoid tumors on her liver that metastasized there from somewhere else in her body. We were never able to identify the primary site. They also told us that 10-15% of primary sites are never found.

Nine months later

On Thursday, August 4, 2005 when I walked into the hospital room, something was distinctively different. Besides the fact they had covered her eyes with gauze to prevent the fluid from dripping, she just looked different. She ­was more yellow, more lifeless. I looked at the heart monitor and saw that for the first time since she had been in ICU, her heart beat had dropped below 100. It was hovering at 135-140 since she went into the coma 6 days before. Seeing her like that made my stomach churn. I knew the inevitable was upon us. After all, the doctors had been telling us for days that we should make a decision because we were just prolonging her death. But as a 39 year old mother of 9, her role in our lives was just too important to make that kind of decision. I was secretly hoping she'd make it herself. I leaned over her, kissed her and said, "Joanne, its ok if you want to go. I really don't want you to because we need you here but I understand if you need to go." I cried and caressed her hair and face and repeatedly kissed her forehead.

When her mother and 3 brothers arrived I could sense their uneasiness. We requested a meeting with the doctor who told us they had stopped one of her medicines that kept her blood pressure up because it was making her extremities purple. He said if they stopped the other one she would surely die, although he didn't know how soon.

My brother-in-law Chris asked the doctor if they had learned anything from Joanne’s situation. He said, “We learned how to have faith because of the belief that you as a family have displayed.” That was an awesome thing for him to say and attested to our power of faith as a family.

As the day progressed we discussed our options. There weren't really any options at all but to take her off the second medicine and hope she would recover. We decided that we would stop the medicine at 6 p.m. Looking back I have no idea why we made that decision. Maybe to give ourselves enough time to say good bye.

Her brothers called their wives so they could come and say good bye and I called my family and Joanne's best friend Steve. I knew Joanne would want him to be there.

At 7 p.m. we were sitting in the waiting room waiting for others to arrive. I was agonizing over the decision we made to stop the medicine. Looking at my watch, I stood up and said to Steve and Joanne's brother Chris, "If we're going to do this, we have to do it now before I change my mind."

I walked down the hall to Joanne's room like I was taking the last walk of my life. In a sense, it was the last walk of the life I knew and loved. The walls, floor, doors and windows of the rooms and waiting areas all seemed to go by in slow motion. In her room, there were people around her bed. I wiggled my way through them and stopped and looked into her face. I remember how orange the sky was out her window. It was a mixture of orange with a purple hue. The sun was setting on more than just a day.

I bent down, gave her a gentle hug and nestled my face in her brown hair like I've done a thousand times before. I breathed her in deeply one last time. I stayed there forever. I told her how much I loved her, how I would miss her so much and how I didn't know what we'd do without her. I cried hard for a long time drying my tears in her hair. I didn't care who heard me or what they were thinking. This was my time with my baby and nothing else mattered. Just me and her, alone again.

When I was done crying, I stood up and wiped my eyes. I breathed in a great, shaking breath. I looked at Chris and said, "Go tell the nurse to stop the medicine." He asked me if I was sure and I told him I was. I turned to sit down and when I did, Joanne's heart beat dropped from 80 to 38 to zero. In a matter of 15 seconds, without the nurse doing anything, she was gone and my life was changed forever. I said to the nurse, “Did you stop the medicine already?” She said, “No, I haven’t done anything. She’s doing what she knows she needs to do.”

Joanne gave me the greatest of all gifts that night by making the decision on her own like I had hoped by waiting for me to say goodbye. This also confirmed that she could hear us while she was in her coma as we all talked to her and expressed our love to her. She knew it was time to go home. Goodbye my love.

I left the hospital at 10:30 p.m., three hours after Joanne died. Now came the hard part – telling the kids. The drive home was scary. I felt alone. It was dark and I was so exhausted, so in shock. I remember driving through very familiar areas not really knowing where I was. They were places Joanne and I had driven hundreds of times during our early years together. But this night they were strange places. I remembered receiving a call from my boss, who was surprised that I picked up the phone. He had intended on leaving a message. I answered because I was terrified to be alone. A feeling I later discovered that was inevitable and one that I had to fight through during the early months of my grief.

When I got to my parents house, there were cars parked up and down the street. The older kids, Nicole, Richie, Matthew and Jessica weren’t there because they were at a camp dance for the night. My two brother-in-laws, Fred and Lou, went to pick them up. Some of the younger kids were home and sleeping. I think Sarah was the only one who was awake. A few minutes after I got there, Fred and Lou came in with the older kids. I remember standing at the top of the stairs when the doors opened. I saw them and told them to immediately go downstairs where I had to talk to them. I just didn’t know how else to handle it. They looked at me funny and went downstairs. Sarah was upstairs so I told her to go down as well. Then I asked my mother and Joanne’s mother if they would come down with me.

We walked down the stairs and around the corner to find them sitting on the couches waiting for us. I could tell they knew something was up. I remember turning around to make sure that both my mother and mother-in-law were close behind. I looked at my kids and said, “I have to tell you guys something.” I paused as my eyes filled up and my body started to tremble. Through my tears I looked at them as best I could and said, “Guys, Mom died tonight.”

Everyone started crying except my 12 year old Richie. He burst into screams, looked me in the eye and said, “I HATE YOU!” He ran out of the house and was gone for quite some time. My brothers were able to find him and calm him down. He was the closest to Joanne and was the most visibly upset. Since then Richie has gone through some intense grief therapy and is doing much better today. He still has a ways to go but he’s a different kid than the first year.

My 2 oldest daughters are also going through therapy and doing ok. The younger ones will probably have to go through therapy at some point too. They all still miss their mom terribly. My oldest children don’t talk about it much but I know they are hurting. I try to remain open to what they’re feeling and be available and at the same time aware of when they may need counseling. My 11, 10, 8, 7 and 5 year old daughters still cry occasionally. It comes usually at bed time when they are quieting down for the night and have time to think about the scope of everything. Emily, my 5 year old, says several times a week at bedtime, “I miss mommy.” It’s heartbreaking and a harsh reminder of how devastating it still is to even me. James, my 3 year old and youngest, knows that Mommy died and is in heaven with God but he doesn’t remember her. And that’s the hardest part of all – I know as each year goes by their memories of her are going to fade and they probably won’t remember her at all at some point. I’m trying my best to keep her memory alive through stories and photos.

All of the children lead normal lives today with the exception of the things I talked about above. They all have good friends and are happy. Everyone tells me what a good job I’m doing but I know it’s not just me. We have a great group of people who have taken parts in our lives. I also know that Joanne has her hand in how things are going. We’ve managed to move back to the Northeast (we were living in Atlanta, GA when she first got sick) to be closer to our family. It’s a move that has really benefited us.

The past 2 years there have been lessons learned and insights gained. We are very thankful for all the people who have come into our lives since then. We could not have come this far without them. We continue to ask for thoughts and prayers and know that with God’s help, we are going to be ok.

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